In female patients with acute anorexia nervosa, plasma leptin concentrations are
well below those of female controls matched for age, body mass index, and/or
percent body fat. The low levels presumably reflect the restricted energy intake
of these patients. The reduced leptin synthesis is likely to be involved in the
pathogenesis of amenorrhea and the reduced metabolic state of acutely ill
individuals. Weight gain leads to steep increases in leptin synthesis, resulting
in leptin plasma levels that peak at values well in excess of those of female controls.
This phenomenon might underlie increased energy expenditure which has previously
been observed upon short-term weight restoration. At this stage patients might
therefore be especially vulnerable to renewed weight loss. Leptin levels drop
into the control range several weeks after attainment of the target weight,
indicating normalization. In patients who subsequently lose weight anew leptin
levels again drop below the control range.

For further information, please
contact the corresponding author, Professor Johannes Hebebrand at the University
of Marburg, Germany; e-mail: Hebebran@post.med.uni-marburg.de; Tel.:
+49-6421-286466; Fax: +49-6421-283056. The relevance of these findings is
independently reviewed in an editorial to be published in the same issue of
Molecular Psychiatry by the journal editor, Julio Licinio, M.D.; phone:
301-496-6885; FAX: 301-402-1561; e-mail: licinio@nih.gov

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